Smith NSAIDs, Glucocorticoids, DMARDs

Question 1

Mechanism of NSAIDs

Answer 1

Inhibit Cyclooxygenase enzymes

Question 2

Mech of Glucocorticoids

Answer 2

Inhibit phospholipase A2 (PLA2)

Question 3

WHat does DMARD stand for

Answer 3

Disease modifying anti-rheumatic drugs

Question 4

Types of DMARDs

Answer 4

1) Non - biologic

Biologic

Question 5

What are eicosanoids

Answer 5

Oxygenation products of poly-unsaturated long-chain FA

Question 6

In what fashion do eicosanoids act?

Answer 6

Autocrine

Paracrine

Question 7

What type of proteins are eicosanoids

Answer 7

G coupled protein

Question 8

Prostanoid is a sub classification of

Answer 8

Eicosanoids

Question 9

Types of prostanoids

3

Answer 9

Prostaglandins
Thromboxanes
Prostacyclins

Question 10

Prostanoids have major effects on?

5

Answer 10

1) Platelets and blood cells
2) Adipose Tissue
3) nerve terminals
4) endocrine organs
5) smooth muscle
BANES

Question 11

Difference in function b/w COX1 or COX 2 inhibitors

Answer 11

COX 2 selective inhibitors do NOT inhibit platelet aggregation or cause GI upset/ulceration

Question 12

3 NSADIS are

Answer 12

aspirin
ibuprofen
naproxen

Question 13

contraindication of aspirin

Answer 13

Bleeding disorders
ace nhibitor
methotrexate
children with viral induced illness (reyes syndrome)

Question 14

mechanism of nsaids

Answer 14

non - selective cox1 and 2 inhibition

Question 15

what is the only nsaid to inhibit both COXs in an irreversible manner?

Answer 15

aspirin

Question 16

what is aspirin primarily valued for?

Answer 16

anti-platalet aggregation effects

Question 17

when is aspirin used for anti-inflammatory purposes?

Answer 17

RARE bc needs too high of a dose

Question 18

ibuprofen function

Answer 18

analgesic
antipyretic
anti-inflammatory

Question 19

what does ibuprofen interfere with

Answer 19

antiplatalet effect of aspirin

Question 20

what makes naproxen unique?

Answer 20

slow-release

Question 21

adverse effects of all nsaids

Answer 21

GI problems

Reyes syndrome

Question 22

what is the name of a cox 2 selective inhibitor

Answer 22

celecoxib

Question 23

celecoxib functions

Answer 23

analgesic
antipyretic
anti-inflammatory

Question 24

what effect does celecoxib have on platalet aggregation

Answer 24

none

Question 25

how much more selective for cox 2 is celecoxib

Answer 25

10-20x

Question 26

acetaminophen mechanism

Answer 26

effect on hypothalamus to reduce fever | analgesic mech through elevation of pain threshold

Question 27

what is adverse effect of acetaminophen

Answer 27

liver failure

Question 28

is acetaminophen anti-inflammatory

Answer 28

NOOO!O

Question 29

Glucocorticoids mech in depth

Answer 29

prevents conversion of membrane phospholipids to arachidonic acid by inhibiting the phospholipase A2 enzyme

Question 30

short to medium actic glucocorticoids are

Answer 30

hydrocortisone cortisone prednisone

Question 31

ling acting glucocorticoid is

Answer 31

dexamethasone

Question 32

prednisone mech

Answer 32

blocks phospholipase A2, thus shutting down immune response

Question 33

non-biologic dmard mech

Answer 33

supress progression of disease by actions against underlying immunological abnormalities

Question 34

two non biologic dmards are

Answer 34

methotrexate | azathioprine

Question 35

what is the 1st line dmard for rheumatoid arthritis

Answer 35

methotrexate

Question 36

methotrexate mech

Answer 36

inhibits transformylase and thymidylate synthetase

Question 37

methotrexate adverse efects

Answer 37

contraindicated in pregnancy | contraindicated with nsaids

Question 38

azathioprine mech

Answer 38

supresses dna synthesis and production of b-cells and t cells

Question 39

azathioprine adverse effects

Answer 39

bone marrow supression

Question 40

what size of molecules are biologic dmards

Answer 40

large molecules

Question 41

two biologic dmards are

Answer 41

(abatacept) t-cell modulators | (adalimumab) tnf alpha blocking agents

Question 42

abatacept mech

Answer 42

fusion protein that prevents activation of t-cells

Question 43

abatacept monthly cost?

Answer 43

3700

Question 44

adalimumab mech

Answer 44

prevents ligand from binding to tnf alpha receptor

Question 45

4 human monoclonal antibody options are

Answer 45

1) infliximab 2) adalimumab 3) certolizumab pegol 4) golimumab